Healthier Together

Fall 2017 issue
State of the heart

State of the heart


It started with just a little bit of chest pain — insignificant enough that Melinda Masters thought it was nothing more than a twinge of asthma.

So she took an aspirin at the kitchen sink and headed to the shower to get ready for a special screening of the new “Star Wars” movie with her family. But when she raised her arms to shampoo her hair, the pain magnified.

“This was the worst pain I’ve ever experienced,” said Masters, a veteran of horseback riding injuries and a serious automobile accident. “I might be more aware of pain than other people, and I have a very, very high tolerance for pain. But I don’t know how you could deny this pain.”

Masters stepped out of the shower and told her husband — quite calmly — to call 911. She was having a heart attack.

Her diagnosis: ST-segment elevation myocardial infarction, or STEMI, an acute type of heart attack that happens when a blood clot completely blocks a coronary artery.

Masters’ heart was saved by her quick reaction and a Novant Health UVA Health System protocol that ensures physicians read EKG results in less than three minutes. She was treated at Novant Health UVA Health System Prince William Medical Center, where door-to-balloon time — the time it takes to restore blood flow to the patient — is well below national averages (see “Time and STEMI”).

“This type of heart attack has to be managed in a short amount of time because you have a large amount of muscle that’s dying by the minute,” said Masters’ cardiovascular disease specialist, Ara Maranian, MD, leader for heart and vascular services for Novant Health UVA Health System. “The faster you open the vessel, the better the prognosis.”

Young, healthy and caught off guard

You would never call Masters a typical candidate for a heart attack, Dr. Maranian said. At 48 years old, she exercised daily and followed a healthy diet. She wasn’t overweight. Her only risk factors were genetics — her mother, brother and uncle have had heart attacks — and a history as a smoker.

In fact, because of her genetics, Masters sought the care of a cardiologist in early 2016. She was prescribed daily aspirin to stave off a heart attack. Months before she felt that first STEMI spasm in her chest, she had received word that if she followed her aspirin regimen, the doctor did not foresee her having a heart attack given her stress test results.

“To say that the heart attack caught me off guard is a huge understatement,” Masters said.

But as the pain that December afternoon worsened, she mined her experience as a former fire and rescue volunteer to remain calm (she even practiced meditative breathing during the ambulance ride) and, most importantly, to recognize her pain — and react to it.

Dr. Maranian said far too many people ignore or try to ride out their pain. And it’s not worth the gamble.

“If you think it’s your heart and you’re wrong, it’s no big deal,” he said. “If it’s the other way around, you might die or bear permanent damage that affects your overall lifestyle after the fact.”

Life after a STEMI

Masters has completed her post-surgery rehabilitation and is back at the gym with her kids, trying to teach them about balanced workouts that include strength training as well as cardio for good heart health.

She does wear out more easily now, and she says she has had to set a new “100 percent performance” standard for herself. She knows that if she has a busy Tuesday, for instance, she needs to slow down on Wednesday. She works with a nutritionist at Prince William Medical Center to learn more about protein-rich, balanced meals that fuel her body steadily throughout the day.

With continued care and monitoring, her body will perform like it did before the STEMI, Dr. Maranian said.

And with younger and younger patients experiencing heart attacks, Dr. Maranian said Masters sets a good example for anyone who notices chest pain: stay calm and act fast.

“If you get in really quickly and you can open the vessel, you can actually walk away with no damage to your heart,” he said.

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